＜論文紹介：NEJM 2024;391:1529-1538.ほか＞

NEJMがとても役立ちますよ、ということを以前お話ししましたが、最近のNEJM論文を紹介します。

「Case 33-2024: A 71-Year-Old Woman with Confusion, Aphasia, and a Brain Mass.（NEJM 2024;391:1529-1538.）」
NEJMのCase Recordsで登場する放射線科医のコメント・解説は、いつも表層的な印象です。

Figure 3の冠状断MRIがヒントのように思います。

「IMAGES IN CLINICAL MEDICINE: Secondary Syphilis with Osteitis.（NEJM 2024;391:1342.）」
梅毒は骨病変も生じます。

 

「Case 31-2024: A 37-Year-Old Man with Fever, Myalgia, Jaundice, and Respiratory Failure.（NEJM 2024;391:1343-1354.）」
急性肺病変を呈する疾患として覚えておきたい病態です。

「Case 30-2024: A 45-Year-Old Woman with Kidney Lesions and Lytic Bone Disease.（NEJM 2024;391:1140-1151.）」

高ガンマグロブリン血症を呈する病態や鑑別疾患を学べます。

 

他のNEJM関連は、こちら。

（かなり数がたまったので今後はリンクははりません。ご了承ください。内容を記載しますので、ご関心があればリンク先アドレスをコピペしてご参照ください。）

（https://ocu-radiology.jp/news/news-5083/）
Primary Central Nervous System Vasculitis.
Pancreatic Cysts.
A New Orthonairovirus Associated with Human Febrile Illness.
Nutritional optic neuropathy due to multiple nutritional deficits, including vitamin A, copper, and zinc deficiencies.

（https://ocu-radiology.jp/news/news-5052/）
Paraneoplastic encephalomyelitis due to small-cell lung carcinoma and concurrent cerebral amyloid angiopathy.
Sweet’s syndrome.
Common variable immunodeficiency.
Congenital and Acquired Chiari Syndrome.

（https://ocu-radiology.jp/news/news-4953/）
Reversible cerebral vasoconstriction syndrome with takotsubo cardiomyopathy.
T-Cell Cancer after CAR T-Cell Therapy.
Highly Pathogenic Avian Influenza A(H5N1) Virus Infection in a Dairy Farm Worker.
MIDD (maternally inherited diabetes and deafness) and MELAS (mitochondrial encephalopathy, lactic acidosis, and strokelike episodes) associated with the m.3243A→G pathogenic variant.

（https://ocu-radiology.jp/news/news-4726/）
Anti–Interleukin-23 Autoantibodies in Adult-Onset Immunodeficiency. Kidney Injury and Hair-Straightening Products Containing Glyoxylic Acid. Myeloperoxidase antineutrophil cytoplasmic antibody–associated vasculitis. Behçet’s Syndrome.

（https://ocu-radiology.jp/news/news-4624/）
Coccidioidomycosis and Histoplasmosis in Immunocompetent Persons.Keratinizing desquamative squamous metaplasia due to vitamin A deficiency occurred after a bariatric operation. Syphilis Complicating Pregnancy and Congenital Syphilis.

（https://ocu-radiology.jp/2024/01/04/post-4597/）
Hereditary angioedema. Cronkhite–Canada syndrome.
Methemoglobinemia Outbreak in a Neonatal ICU and Maternity Ward.
Eye Infections.

（https://ocu-radiology.jp/news/news-4583/）
Chorea due to antiphospholipid syndrome and underlying systemic lupus erythematosus.
Schnitzler’s syndrome.
HNF1B-related disease consistent with renal cysts and diabetes spectrum disorder.
Liver Transplantation in a Woman with Mahvash Disease.

（https://ocu-radiology.jp/news/news-4552/）
Granulomatous lung disease as an extraintestinal manifestation of inflammatory bowel disease.
Primary pericardial mesothelioma without pleural involvement. Carcinoid heart disease due to a metastatic well-differentiated
neuroendocrine tumor (carcinoid tumor) associated with carcinoid syndrome.

（https://ocu-radiology.jp/news/news-4460/）
Noncirrhotic hyperammonemia after Roux-en-Y gastric bypass.
Periengraftment respiratory distress syndrome, a subtype of idiopathic pneumonia syndrome.
Current and Emerging Issues in Wilson’s Disease.

（https://ocu-radiology.jp/news/news-4383/）
Protein-Losing Enteropathy.
Juvenile granulosa-cell tumor.
Multiple vitamin deficiencies, including vitamin C deficiency.
Systemic Inflammation and Normocytic Anemia in DOCK11 Deficiency.
Histoplasmosis.
RAS-associated autoimmune leukoproliferative disorder.
Congenital absence of the main portal vein with a congenital extrahepatic portosystemic shunt (Abernethy malformation).

（https://ocu-radiology.jp/news/news-4306/）
Systemic immunoglobulin light-chain (AL) amyloidosis.
Sarcoidosis associated with tattoos.
Mansonella perstans infection.

（https://ocu-radiology.jp/news/news-4250/）
Cystic fibrosis Functional vitamin B12 deficiency from use of nitrous oxide.
The Current and Future State of AI Interpretation of Medical
Images.

（https://ocu-radiology.jp/news/news-4177/）
Arterial calcification due to deficiency of CD73.
Systemic lupus erythematosus with membranous lupus nephritis.
A hepatic brucelloma.

（https://ocu-radiology.jp/news/news-4096/）
Paraneoplastic vasculitis of the central nervous system.
Primary biliary cholangitis with portopulmonary hypertension.
Catastrophic antiphospholipid syndrome.

（https://ocu-radiology.jp/news/news-4062/）
Hepatic adenoma, inflammatory type, with associated ischemic necrosis and extensive hemorrhage.
Cardiac paraganglioma with a germline mutation in the gene encoding succinate dehydrogenase subunit C (SDHC).
Primary Ovarian Insufficiency.
Cushing’s syndrome due to ectopic secretion of adrenocorticotropic
hormone from small-cell lung cancer.

（https://ocu-radiology.jp/news/news-4035/）
Adrenocortical carcinoma.
Disseminated Mycobacterium tuberculosis infection.
Whipple’s disease.
Optic nerve sheath meningioma.
Sarcoidosis.

（https://ocu-radiology.jp/news/news-3897/）
IgA vasculitis.
Granulomatosis with polyangiitis.
Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome.
Neonatal hypoglycemia due to biologically active teratoma and
the Sotos syndrome.

（https://ocu-radiology.jp/news/news-3897/）
Langerhans-cell histiocytosis of the lung and liver.
Chronic Candida albicans meningitis.
Bronchiectasis — A Clinical Review.
Exogenous lipoid pneumonia with a supportive history of mineral oil ingestion.

（https://ocu-radiology.jp/news/news-3861/）
Takayasu’s arteritis.
Granulomatosis with polyangiitis.
Infection with Blastomyces dermatitidis.

（https://ocu-radiology.jp/news/news-3787/）
Spinal gout.
Aspiration pneumonia.
Idiopathic multicentric Castleman’ s disease (TAFRO subtype).

（https://ocu-radiology.jp/news/news-3734/)
Constrictive bronchiolitis due to military service. Cryptogenic Organizing Pneumonia. Hereditary angioedema type I due to heterozygous deletion of exons 5 and 6 in SERPING1.

（https://ocu-radiology.jp/news/news-3654/）
Multistate Outbreak of Melioidosis Associated with Imported Aromatherapy Spray.
Fever of Unknown Origin.
post–Covid-19 Hemophagocytic lymphohistiocytosis (HLH).

（https://ocu-radiology.jp/news/news-3608/）
VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome.
Anti-IgLON5 IgG–associated neurologic disorder. HHV-6 encephalitis associated with CD19-directed CAR-T therapy.

（https://ocu-radiology.jp/news/news-3589/）
Fat embolism syndrome. Anti–melanoma differentiation–associated protein 5 (anti–MDA-5) dermatomyositis.
Legionella pneumonia. Spontaneous Intracranial Hypotension.

（https://ocu-radiology.jp/news/news-3561/）
Pneumocystis jirovecii pneumonia. Seizure from neurocysticercosis.
Primary hyperparathyroidism and brown tumor.
Vascular Ehlers–Danlos syndrome.

（https://ocu-radiology.jp/news/news-3513/）
Systemic juvenile idiopathic arthritis. Challenges of Sarcoidosis and Its Management.
Chronic Meningitis. Acute human immunodeficiency virus type 1 infection.

（https://ocu-radiology.jp/news/news-3490/）
Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) due to a biallelic expansion in RFC1.
Delayed posthypoxic leukoencephalopathy.
Vasculopathy and myocardial infarction associated with Neurofibromatosis type 1.
Nodular follicular thyroid neoplasm with a somatic NRAS mutation.

（https://ocu-radiology.jp/news/news-3354/）
Adrenal Incidentaloma. Bartonella henselae infection (cat scratch disease).
Suprasellar CNS germinoma. Extrahepatic Manifestations of Chronic HCV Infection. Leptospirosis.

（https://ocu-radiology.jp/news/news-3212/）
Lymphoplasmacytic lymphoma of the central nervous system(Bing–Neel syndrome).
Disseminated Mycobacterium bovis infection.
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. Systemic primary amyloidosis.

（https://ocu-radiology.jp/news/news-3133/）
Mycobacterium tuberculosis meningitis. Vaginal Transmission of Cancer from Mothers with Cervical Cancer to Infants.
Somatic Mutations in UBA1 and Severe Adult-Onset Autoinflammatory Disease.
Cryptococcal meningoencephalitis and advanced human immunodeficiency virus infection.

（https://ocu-radiology.jp/news/news-3082/）
Primary hyperparathyroidism due to an ectopic parathyroid carcinoma.
Necrotizing granulomatous lymphadenitis due to Mycobacterium tuberculosis complex.
Tuberculous pericarditis.
Aceruloplasminemia, hereditary. Sensory Ganglionopathy. Borrelia miyamotoi infection. Autophagy in Human Diseas.

（https://ocu-radiology.jp/news/news-3050/）
Disseminated cryptococcosis. Cryptococcus neoformans. Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.
boric acid toxicity.
Human immunodeficiency virus type 2 infection and cerebral toxoplasmosis. New-Onset Diabetes in Covid-19.

（https://ocu-radiology.jp/news/news-3023/）
Pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Lead poisoning.
Acute Ischemic Stroke. Degenerative Cervical Spondylosis.

（https://ocu-radiology.jp/news/news-2980/）
Whipple’s disease. Variant Creutzfeldt–Jakob Disease. Down Syndrome.
Phosphaturic mesenchymal tumor. LGI1 autoimmune encephalitis.

（https://ocu-radiology.jp/news/news-2903/）
Fascioliasis (Eosinophilia). Proteinase 3 antineutrophil cytoplasmic antibody–associated vasculitis consistent with granulomatosis with polyangiitis. Hantavirus cardiopulmonary syndrome. PSA Screening.

（https://ocu-radiology.jp/news/news-2788/）
Intraparenchymal and intracranial hemorrhage presumably due to birth trauma.
小児虐待. Pulmonary tumor thrombotic microangiopathy.

（https://ocu-radiology.jp/news/news-2758/）
A Novel Coronavirus from Patients with Pneumonia in China, 2019.
Treatment for Spontaneous Pneumothorax. Fatal Cytomegalovirus Infection with Inherited NOS2 Deficiency.
Strongyloidiasis with human T-lymphotropic virus type 1 infection.
Disseminated coccidioidomycosis and ANCA-associated glomerulonephritis.
Photopheresis for Colitis Induced by Checkpoint-Inhibitor Therapy.
Machine Learning and the Cancer-Diagnosis Problem.
Diffuse pulmonary alveolar hemorrhage with focal infarction with vaping.

（https://ocu-radiology.jp/news/news-2601/）
Identification of Anonymous MRI Research Participants with Face-Recognition Software.
Cerebellar form of Creutzfeldt–Jakob disease.
Adenovirus meningoencephalitis. Imaging of Vaping-Associated Lung Disease.

（https://ocu-radiology.jp/news/news-2550/）
Interstitial lung disease associated with FLNA mutation. Spondyloarthritis in patients with inflammatory bowel disease (Crohn’s disease).
Inhaled GM-CSF for Pulmonary Alveolar Proteinosis.

（https://ocu-radiology.jp/news/news-2464/）
Pregnant woman with Acute suppurative appendicitis and periappendicitis.
Pheochromocytoma and Paraganglioma. Drug-Induced Liver Injury.
New Guidelines for Statistical Reporting in the Journal.

（https://ocu-radiology.jp/news/news-2436/）
Leber’s hereditary optic neuropathy. Kelch-like Protein 11 Antibodies in Seminoma-Associated Paraneoplastic Encephalitis.
Intestinal tuberculosis.

（https://ocu-radiology.jp/news/news-2403/）
Anaplastic carcinoma arising in association with intestinal-type mucinous carcinoma of the ovary.
（いわゆるMucinous cystic tumours with mural nodules）
West Nile virus encephalitis/West Nile virus meningoencephalitis.

（https://ocu-radiology.jp/news/news-2371）
Systemic lupus erythematosus. Contrast-Associated Acute Kidney Injury.
Mesenchymal Hamartoma of the Liver and DICER1 Syndrome.
Metastatic postpubertal immature teratoma. Machine Learning in Medicine.

（https://ocu-radiology.jp/news/news-2148/）
Idiopathic pulmonary fibrosis. Pulmonary alveolar proteinosis.
Mucinous Ovarian Carcinoma. Ocular syphilis.

（https://ocu-radiology.jp/news/news-2115/）
Herpes simplex virus lymphadenitis, Chronic lymphocytic leukemia.
Perforation of the sigmoid colon by a foreign body (toothpick) that caused a fistula to the right common iliac artery. Powassan virus encephalitis.

（https://ocu-radiology.jp/news/news-2037/）
Papulonecrotic tuberculid (cutaneous tuberculosis).
Hepatobiliary Tuberculosis. Sudden death caused by pulmonary fat embolism in a patient with miliary tuberculosis.

（https://ocu-radiology.jp/news/news-1974/）
眼窩領域Granulomatosis with polyangiitis, Susac’s syndrome.
Clostridium perfringens bacteremia with a hepatic abscess.
Osteoblastic and Osteolytic Spine Metastases by Using SWI.

（https://ocu-radiology.jp/news/news-1921/）
The t(6;11) TFEB translocation variant of renal-cell carcinoma.
比較的新しい病理組織概念でUncommonな腎腫瘤の復習.

（https://ocu-radiology.jp/news/news-1901/）
Pulmonary adenocarcinoma, hypercoagulable state with nonbacterial thrombotic endocarditis.
BK Virus–Progressive Multifocal Leukoencephalopathy.

（https://ocu-radiology.jp/news/news-1843/）
Anti–N-methyl-d-aspartate (NMDA) receptor encephalitis.
The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, associated with human herpesvirus 6. Acute Viral Encephalitis.
特にarbovirus encephalitisについて.

（https://ocu-radiology.jp/news/news-1793/）
Vitamin C deficiency (scurvy).“bachelor scurvy” Vitamin B6, folate, zinc, and selenium deficiencies.
Alcohol-use disorder. Multiple vitamin deficiencies.

（https://ocu-radiology.jp/news/news-1681/）
Polyarteritis nodosa. HBVとの関連.

（https://ocu-radiology.jp/news/news-1605/）
Membranous nephropathy, PLA2R type. IgG4との関連性など. Idiopathic Pulmonary Fibrosis.

（https://ocu-radiology.jp/news/news-1588/）
Giant-cell myocarditis. Takotsubo cardiomyopathy and catecholamine-induced crisis due to pheochromocytoma.
Fulminant Myocarditis with Combination Immune Checkpoint Blockade.

（https://ocu-radiology.jp/news/news-1462/）
Homocystinuriaの様々な表現型：Cystathionine β-synthase deficiency, Methylenetetrahydrofolate reductase deficiency.
Primary Sjögren’s Syndrome. Antibody-Mediated Encephalitis.

（https://ocu-radiology.jp/news/news-1374/）
Immune-Related Adverse Events Associated with Immune Checkpoint Blockade.
Multiple Sclerosis. Neuromyelitis Optica Spectrum Disorders.
Adenovirus infection, disseminated.

（https://ocu-radiology.jp/news/news-1253/）
Biotin–thiamine–responsive basal ganglia disease.

（https://ocu-radiology.jp/news/news-1109/）
好酸球増多症（Eosinophilia）について.

（https://ocu-radiology.jp/news/news-897/）
Copper deficiency. Zincとの関連.

（https://ocu-radiology.jp/news/news-891/）
Takayasu’s arteritis. Atypical immunoblastic reaction that was consistent with primary Epstein–Barr virus infection.

（https://ocu-radiology.jp/news/news-783/）
NEJMの紹介、Case Recordsの変遷についての私見